Travel can be a daunting prospect if you have symptoms of IBS (irritable bowel syndrome). But don’t stress out over vacationing with IBS pain, constipation, diarrhea or frequent trips to the restroom. These expert traveling tips will help you avoid discomfort and have a good time wherever you go…

Linda Sassman counted down the days to her European honeymoon in October 2011 – itinerary set, tickets bought, aisle seat reserved. But deep anxiety gripped her as she started obsessing about the long airport check-in and 12-hour flight.

“All I could think about was needing to run to the bathroom while in the airport security line,” recalls the New Jersey artist, 29.

Sassman has irritable bowel syndrome (IBS), a disorder that affects the large intestine (also called the colon). It causes abdominal pain and cramping along with diarrhea, constipation or a combination of both, says gastroenterologist William D. Chey, M.D., a professor and director of the Gastrointestinal Physiology and Manometry Laboratory at University of Michigan Medical School in Ann Arbor.

As much as 20% of the North American adult population has IBS, and 60%-75% of patients are women, according to the American College of Gastroenterology Functional Gastrointestinal Disorders Task Force. The condition’s exact cause is unknown.

What’s known is that symptoms of IBS can strip the joy from a vacation, doctors say. Many travel-related issues exacerbate the condition, from unfamiliar foods to anxiety, stress and lack of sleep. Meanwhile, you may find it harder to do things that can help ease irritable bowel symptoms, such as getting exercise, having scheduled mealtimes or even taking regular restroom trips.

“On vacation, women feel a lack of control – their meal schedules are disrupted, they don’t know what foods they’re being exposed to [or] where the restrooms are,” says gastroenterologist Caroline Hwang, M.D., assistant professor of medicine at University of Southern California’s Keck School of Medicine in Los Angeles.

“I tell my patients that since stress is known to exacerbate IBS, travel preparation is key.”

Before you board a train, plane or automobile, check out these 10 IBS traveling tips to make the trip more enjoyable and less likely to increase symptoms of IBS.

1. Plan ahead. Consider a restful destination such as a beach or resort, or explore a new place slowly, rather than attempting a jam-packed schedule, such as visiting eight cities in seven days, Dr. Hwang advises. Once there, allow ample time for leisurely meals, restroom breaks and daily exercise.

If traveling by plane, reserve an aisle seat for easy access to the lavatory. Allow enough time at the airport before your flight so you can comfortably get through security and have time for a restroom stop before boarding.

2. Visualize your trip. Dr. Chey recommends this exercise for a calmer vacation: Before you embark on your trip, mentally picture the potential challenges you might face, such as IBS pain and an emergency need for a restroom in an unfamiliar place. Imagine each situation having a positive outcome.

But don’t spend all your time envisioning problems, Dr. Chey warns.

“If you tend to obsess over potential issues, it can create more stress and anxiety, exacerbating your symptoms of IBS,” he says. “It’s a balancing act.”

3. Bring a “survival kit.” If your main IBS symptom is diarrhea, pack a change of clothes and undergarments, a sanitary napkin in case of leakage, baby wipes and a plastic bag in your carry-on luggage, Dr. Hwang suggests. If you’re traveling by car, take a portable toilet, which provides leak- and odor-proof disposable bags, for emergencies.

Also, bring an antispasmodic medication (such as dicyclomine, which reduces cramps) for IBS pain, and an antidiarrheal (such as loperamide, which slows intestinal spasms and thickens stool), Dr. Chey recommends. Keep them in your carry-on bag in case you have symptoms of IBS during your flight.

Both medications are available in capsules and tablets, so you won’t need to worry about taking liquids through security checks.

If you’re prone to diarrhea, pack “binding” foods, such as bananas, rice, applesauce and toast, she adds.

Dr. Chey cautions against pretzels, a common airline snack, because they can cause gas.

During a long flight or drive, avoid alcohol, which irritates the gastrointestinal tract, and caffeinated drinks, which can stimulate intestinal contractions, Dr. Hwang adds.

“Soda isn’t tolerated well, so stay away from all carbonated beverages,” she says.

5. Prepare for restroom breaks. If you’re traveling by car, map out rest stops or gas stations, because some long stretches of highway have few places to stop and no lavatory. Restroom-finder phone apps, such as WhereToWee or SitOrSquat, can help. And always carry change in case you encounter a pay toilet.

At each stop, take a quick walk to break up the sitting and relieve stress, Dr. Hwang suggests. On a plane, keep in mind that the lavatories may be busier at certain times, such as after a movie or right before the seatbelt light goes on in preparation for landing.

If you require frequent restroom trips, avoid buses and passenger boats, which often are cramped and have long wait lines.

6. Use relaxation techniques. Because stress can aggravate IBS pain, practice relaxation exercises before and during your trip, Dr. Hwang advises. Here are some good ones:

Learn deep breathing. Draw a deep breath through your nose, from your abdomen. Exhale through your mouth, pushing out all the air. Repeat about 10 times. “It’s amazing how quickly your heart rate will go down when you breathe deeply,” Dr. Chey says.

Practice “mindfulness.” Spend a few minutes being aware of how you’re feeling in the moment – don’t focus on the past or worry about the future. Repeat a word or phrase that’s meaningful to you, with your eyes open or closed. “Practice mindfulness daily for two weeks before you travel and you’ll be comfortable on the flight,” Dr. Hwang says.

7. Don’t eat that! When you travel, the chance of eating something that irritates your digestive system is higher than it’d be at home. That shrimp cocktail on a street vendor’s cart might look great, but it could be swimming with bacteria.

In other countries, steer clear of raw vegetables and fruits and undercooked seafood and meats. Drink only bottled beverages.

“It’s OK to sample safe local foods; just make sure they’re well-cooked and eat them in moderation,” Dr. Hwang says.

Also, avoid sweets, lactose or gluten if they exacerbate your symptoms of IBS.

When you make hotel reservations, ask to have a refrigerator installed in your room to store safe snacks and drinks, Dr. Hwang suggests. And keep a supply of easy-to-carry items such as protein bars, nuts and oatmeal packets.

Have relaxing, leisurely meals, and remember to eat several small meals, rather than three larger ones, she adds. And resume your regular mealtimes as soon as you can, even when you’re in a different time zone.

8. Maintain your sleep schedule. For some travelers, sleep on a plane is as elusive as a good on-board meal. But try to rest anyway, especially on overnight and transcontinental flights, Dr. Hwang advises.

There’s a good reason for that. People with shifting sleep schedules are more likely to have IBS, according to a 2010 University of Michigan study of nurses. That’s because the colon has its own biological clock, the researchers said. Odd hours of wakefulness disrupt that rhythm, creating symptoms of IBS such as diarrhea, bloating and constipation.

Melatonin, a natural hormone available as an over-the-counter supplement, helps regulate sleep and wake cycles. Some doctors prescribe it for patients with sleep problems and jet lag.

“It also helps ease abdominal pain,” Dr. Chey says. “It’s good for a long flight.”

Take 0.5 mg-5 mg of melatonin one hour before the bedtime of your final destination, the University of Maryland Medical Center suggests. Check with your doctor for suggestions about the best dose for you.

Over-the-counter antihistamines such as diphenhydramine or doxylamine, or doctor-prescribed sleeping pills, can also make you drowsy enough to sleep on a plane. Ask your doctor about potential side effects, such as dry mouth and dizziness.

If you’re tired when you arrive at your destination, take a 30-minute nap only, then get a full night’s sleep at bedtime, Dr. Hwang suggests. That will help you acclimate to a new time zone.

9. Take care of medication and doctor visits. These tips will make sure you have access to the care you need, according to Dr. Hwang and other sources:

Have your IBS prescription medications filled well before you travel – don’t wait for the last minute. Some insurance plans allow you to get an early refill for a vacation.

Ask your physician for an extra prescription that can be filled at your destination city. Divide your medications into two containers in case you lose one. Keep one with you and the other in your suitcase or hotel room.

Take a five-day course of antibiotics with you in case of an intestinal infection. Most doctors will give a preventive prescription to IBS patients who are traveling abroad, Dr. Hwang says.

Carry your physician’s contact information with you; if traveling abroad, rent or buy an international cell phone to reach your doctor easily in an emergency. “Your doctor may not be able to help you directly, but [he or she] can help determine if your condition is serious enough to see a doctor [where you are],” Dr. Hwang says.

If you have diarrhea not caused by an infection, take loperamide; you can use it preventively if you’re facing a long bus or plane ride. If you experience intestinal distress and can’t reach a doctor, sip some chamomile or peppermint tea, which helps with cramping, Dr. Hwang recommends.

10. Accept your condition. If you have IBS, it’s easy to feel aggravated that you have to work so hard to prevent accidents or discomfort when traveling. But there’s a positive side, Dr. Chey says.

“Remember that unlike gastrointestinal diseases such as celiac – where eating gluten can be dangerous or [life-threatening] – IBS sensitivities don’t lead to cancer or other serious consequences,” he notes.

Planning ahead empowers you to do what other travelers can do, Dr. Hwang adds.

“It’s better to not have IBS, but people with diabetes have to be prepared at all times too,” she says. “It’s worth it to enjoy your vacation.”

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